Precision individualized medication strategies and challenges for cardiovascular diseases

Abstract

With the ongoing societal development and changes in lifestyle, the incidence of cardiovascular diseases continues to rise. Although the most effective means of preventing atherosclerotic cardiovascular disease, heart failure, and atrial fibrillation is the lifelong promotion of a healthy lifestyle, pharmacological treatment plays a critical role in the comprehensive management of cardiovascular diseases, with an increasing demand for effective drug management. Effective medication management aids in controlling disease progression, reducing the occurrence of complications, and improving patients' quality of life. Therefore, understanding and mastering the importance of drug toxicity and prescription review in the management of cardiovascular diseases is crucial. Moreover, outpatient time plays a pivotal role in the treatment and recovery of patients. Through appropriate medication management and outpatient practices, better patient management and personalized medical services can be achieved. This paper will focus on discussing the significance of drug toxicity and prescription review in the context of cardiovascular disease management.

Keywords

Precision individualized medication strategies / Cardiovascular diseases / Pharmacological treatment

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Declaration of Competing Interest

The authors declare that they have no competing interests.

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References

[1] Perry AS, Dooley EE, Master H, et al. Physical activity over the lifecourse and cardiovascular disease. Circ Res. 2023; 132(12):1725-1740. https://doi.org/10.1161/CIRCRESAHA.123.322121

[2] Blood Pressure Lowering Treatment Trialists' Collaboration. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis. Lancet. 2021; 397(10285):1625-1636. https://doi.org/10.1016/S0140-6736(21)00590-0

[3] O'Sullivan JW, Raghavan S, Marquez-Luna C, et al. Polygenic risk scores for cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2022; 146(8):e93-e118. https://doi.org/10.1161/CIR.0000000000001077

[4] Wu J, Giles C, Dakic A, et al. Lipidomic risk score to enhance cardiovascular risk stratification for primary prevention. J Am Coll Cardiol. 2024; 84(5):434-446. https://doi.org/10.1016/j.jacc.2024.04.060

[5] Pelter MN, Druz RS. Precision medicine: hype or hope? Trends Cardiovasc Med. 2024; 34(2):120-125. https://doi.org/10.1016/j.tcm.2022.11.001

[6] Touyz RM. Pharmacology and precision medicine-preparing for the next era in clinical medicine-editorial. Pharmacol Rev. 2024; 76(4):559-560. https://doi.org/10.1124/pharmrev.124.001017

[7] Sadee W, Wang D, Hartmann K, et al. Pharmacogenomics: driving personalized medicine. Pharmacol Rev. 2023; 75(4):789-814. https://doi.org/10.1124/pharmrev.122.000810

[8] McFarland MS, Buck ML, Crannage E, et al. Assessing the impact of comprehensive medication management on achievement of the quadruple aim. Am J Med. 2021; 134(4):456-461. https://doi.org/10.1016/j.amjmed.2020.12.008

[9] Duarte JD, Cavallari LH. Pharmacogenetics to guide cardiovascular drug therapy. Nat Rev Cardiol. 2021; 18(9):649-665. https://doi.org/10.1038/s41569-021-00549-w

[10] Liu H, Wang L, Wang H, et al. The association of triglyceride-glucose index with major adverse cardiovascular and cerebrovascular events after acute myocardial infarction: a meta-analysis of cohort studies. Nutr Diabetes. 2024; 14(1):39. https://doi.org/10.1038/s41387-024-00295-1

[11] Duggan JP, Peters AS, Trachiotis GD, et al. Epidemiology of coronary artery disease. Surg Clin N. Am. 2022; 102(3):499-516. https://doi.org/10.1016/j.suc.2022.01.007

[12] Naito R, Kasai T. Obstructive coronary artery disease, a common and curable but critical comorbidity in acute decompensated heart failure. Eur J Heart Fail. 2022; 24(11):2150-2151. https://doi.org/10.1002/ejhf.2665

[13] Dzau VJ, Hodgkinson CP. Precision hypertension. Hypertension. 2024; 81(4):702-708. https://doi.org/10.1161/HYPERTENSIONAHA.123.21710

[14] Precone V, Krasi G, Guerri G, et al. Monogenic hypertension. Acta Biomed. 2019; 90(10-S):50-52. https://doi.org/10.23750/abm.v90i10-S.8759

[15] Franks PW, Cefalu WT, Dennis J, et al. Precision medicine for cardiometabolic disease: a framework for clinical translation. Lancet Diabetes Endocrinol. 2023; 11(11):822-835. https://doi.org/10.1016/S2213-8587(23)00165-1

[16] Qi M, Ma S, Liu J, et al. In vivo base editing of Scn5a rescues Type 3 Long QT syndrome in mice. Circulation. 2024; 149(4):317-329. https://doi.org/10.1161/CIRCULATIONAHA.123.065624

[17] Gutiérrez LK, Moreno-Manuel AI, Jalife J. Kir2.1-Nav1.5 channelosome and its role in arrhythmias in inheritable cardiac diseases. Heart Rhythm. 2024; 21(5):630-646. https://doi.org/10.1016/j.hrthm.2024.01.017

[18] Shoureshi P, Tan AY, Koneru J, et al. Arrhythmia-Induced cardiomyopathy: JACC state-of-the-art review. J Am Coll Cardiol. 2024; 83(22):2214-2232. https://doi.org/10.1016/j.jacc.2024.03.416

[19] Saljic A, Heijman J, Dobrev D. Recent advances in antiarrhythmic drug therapy. Drugs. 2023; 83(13):1147-1160. https://doi.org/10.1007/s40265-023-01923-3

[20] Greene SJ, Bauersachs J, Brugts JJ, et al. Worsening Heart Failure: Nomenclature, epidemiology, and future directions: JACC review topic of the week. J Am Coll Cardiol. 2023; 81(4):413-424. https://doi.org/10.1016/j.jacc.2022.11.023

[21] Johnson S, Sommer N, Cox-Flaherty K, et al. Pulmonary hypertension: a contemporary review. Am J Respir Crit Care Med. 2023; 208(5):528-548. https://doi.org/10.1164/rccm.202302-0327SO

[22] Mocumbi A, Humbert M, Saxena A, et al. Pulmonary hypertension. Nat Rev Dis Primers. 2024; 10(1):1. https://doi.org/10.1038/s41572-023-00486-7

[23] Humbert M, Kovacs G, Hoeper MM, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022; 43(38):3618-3731. https://doi.org/10.1183/13993003.00879-2022

[24] Chu M, Wu P, Li G, et al. Advances in diagnosis, therapy, and prognosis of coronary artery disease powered by deep learning algorithms. JACC: Asia. 2023; 3(1):1-14. https://doi.org/10.1016/j.jacasi.2022.12.005

[25] Klimontov VV, Koshechkin KA, Orlova NG, et al. Medical genetics, Genomics and Bioinformatics- 2022. Int J Mol Sci. 2023; 24(10):8968. https://doi.org/10.3390/ijms24108968

[26] Braunwald E, Saberi S, Abraham TP, et al. Mavacamten: a first-in-class myosin inhibitor for obstructive hypertrophic cardiomyopathy. Eur Heart J. 2023; 44(44):4622-4633. https://doi.org/10.1093/eurheartj/ehad637

[27] Seidah NG, Prat A. The multifaceted biology of PCSK9. Endocr Rev. 2022; 43(3):558-582. https://doi.org/10.1210/endrev/bnab035

[28] Räber L, Ueki Y, Otsuka T, et al. Effect of alirocumab added to high-intensity statin therapy on coronary atherosclerosis in patients with acute myocardial infarction: The PACMAN-AMI Randomized Clinical Trial. JAMA. 2022; 327(18):1771-1781. https://doi.org/10.1001/jama.2022.5218

[29] Karpov OA, Stotland A, Raedschelders K, et al. Proteomics of the heart. Physiol Rev. 2024; 104(3):931-982. https://doi.org/10.1152/physrev.00026.2023

[30] Crooke ST, Baker BF, Crooke RM, et al. Antisense technology: an overview and prospectus. Nat Rev Drug Discov. 2021; 20(6):427-453. https://doi.org/10.1038/s41573-021-00162-z

[31] Khorkova O, Stahl J, Joji A, et al. Amplifying gene expression with RNA-targeted therapeutics. Nat Rev Drug Discov. 2023; 22(7):539-561. https://doi.org/10.1038/s41573-023-00704-7

[32] Yu AM, Choi YH, Tu MJ. RNA drugs and RNA targets for small molecules: principles, progress, and challenges. Pharmacol Rev. 2020; 72(4):862-898. https://doi.org/10.1124/pr.120.019554

[33] Coumau C, Gaspar F, Terrier J, et al. Drug-drug interactions with oral anticoagulants: information consistency assessment of three commonly used online drug interactions databases in Switzerland. Front Pharmacol. 2024; 15:1332147. https://doi.org/10.3389/fphar.2024.1332147

[34] Wiggins BS, Saseen JJ, Page RL, 2nd, et al. Recommendations for management of clinically significant drug-drug interactions with statins and select agents used in patients with cardiovascular disease: a scientific statement from the american heart association. Circulation. 2016; 134(21):e468-e495. https://doi.org/10.1161/CIR.0000000000000456

[35] Barachini S, Ghelardoni S, Varga ZV, et al. Antineoplastic drugs inducing cardiac and vascular toxicity - an update. Vascul Pharmacol. 2023; 153:107223. https://doi.org/10.1016/j.vph.2023.107223

[36] Destere A, Merino D, Lavrut T, et al. Drug-induced cardiac toxicity and adverse drug reactions, a narrative review. Therapie. 2024; 79(2):161-172. https://doi.org/10.1016/j.therap.2023.10.008

[37] Yan G, Han Z, Kwon Y, et al. Integrated Stress Response Potentiates Ponatinib-induced cardiotoxicity. Circ Res. 2024; 134(5):482-501. https://doi.org/10.1161/CIRCRESAHA.123.323683

[38] Lyon AR, López-Fernández T, Couch LS, et al. 2022 ESC Guidelines on cardio-oncology developed in collaboration with the European Hematology Association

[39] ( EHA), the European Society for Therapeutic Radiology and Oncology (ESTRO) and the International Cardio-Oncology Society (IC-OS). Eur Heart J. 2022;43(41 ) :4229-4361. https://doi.org/10.1093/eurheartj/ehac244

[40] DerSarkissian M, Young-Xu Y, Duh MS, et al. The acute effects of azithromycin use on cardiovascular mortality as compared with amoxicillin-clavulanate in US Veterans. Pharmacoepidemiol Drug Saf. 2022; 31(8):840-850. https://doi.org/10.1002/pds.5451

[41] Sun Q, Gong T, Liu M, et al. Shikonin, a naphthalene ingredient: therapeutic actions, pharmacokinetics, toxicology, clinical trials and pharmaceutical researches. Phytomedicine. 2022; 94:153805. https://doi.org/10.1016/j.phymed.2021.153805